Association between sociodemographic characteristics and knowledge and practice of COVID-19 measures among households in Mombasa and Kilifi County, Kenya.

BACKGROUND: Coronavirus disease 2019 (COVID-19), declared a global pandemic by the World Health Organization (WHO), is a severe acute respiratory disease. The Kenyan Ministry of Health (MoH) put in place measures that included mandatory face masking, hand and cough hygiene and social and physical distancing to reduce disease transmission and increase prevention efforts. The primary objective of this study was to determine how sociodemographic characteristics affect knowledge and practice of the above measures. METHODS: A cross-sectional study was conducted to assess water, sanitation and hygiene practices for the prevention and control of COVID-19 in Kilifi and Mombasa Counties, Kenya. Data collection was accomplished through a mobile data collection tool. Principal component analysis was used to create a wealth index using data on asset ownership and housing characteristics. Bloom cut-off points of 80-100%, 60-79% and ≤59% were used to determine knowledge and practice. RESULTS: Of the 612 households, 339 (55.4%) were from Kilifi County and 273 (44.6%) were from Mombasa County. A total of 431 (70.4%) were female and the mean age of the household members was 38.2±14.8 y.Almost all (99.2%) respondents were aware of COVID-19, with 60% knowing prevention, symptoms and persons at a higher risk of contracting the virus. Females had the highest knowledge of COVID-19 and were likely to practice prevention and control measures, unlike males. Age was significant (p<0.05) with knowledge and practice. CONCLUSIONS: The sociodemographic characteristics of populations play a key role in behavioural aspects as far as prevention and control of COVID-19 are concerned. There is a need for partnerships between the MoH and county governments to put in place a multisectoral community approach to advance feasible behavioural interventions among targeted populations towards combating the spread of COVID-19.

Assessment of water, sanitation and hygiene practices for prevention and control of COVID-19 in Kenya.

BACKGROUND: Safely managed water, sanitation and hygiene (WASH) services are an essential part of preventing and protecting human health during infectious disease outbreaks, including the current coronavirus disease 2019 (COVID-19) pandemic. Additionally, adherence to COVID-19 measures, including washing hands using soap and proper waste disposal, no doubt can improve containment of the virus. METHODS: A cross-sectional survey was conducted in Kilifi and Mombasa Counties in Kenya. A total of 612 quantitative data were collected using a mobile data collection tool Open Data Kit. Parametric and non-parametric tests were used to examine factors associated with WASH practices and control of COVID-19 in Kenya. RESULTS: More than half of the respondents were from Kilifi, 431 (70.4%) were female and the mean age was 38.2±14.8 y. Households in Kilifi were most likely not to have enough water, while Mombasa households were more likely to pay for water. Sanitation coverage was 47.6%, with more than half sharing sanitation facilities. Sharing of latrines was significantly associated with county and income level. Accessing soap was worse compared with the month prior to the survey, only 3.9% had their garbage collected by formal service providers and only 17% reported wearing any protective gear while handling waste at home. CONCLUSIONS: Water is disproportionately available in the two counties, with low sanitation coverage. There is low knowledge on hand washing and inadequate waste disposal services.

Knowledge, attitude and practices in relation to prevention and control of schistosomiasis infection in Mwea Kirinyaga county, Kenya.

BACKGROUND: Schistosomiasis remains a major public health problem in Kenya. Inadequate knowledge, attitudes and practices (KAP) on causative factors are some of the critical factors for the increased prevalence. The study assessed KAP on the control and prevention of schistosomiasis infection in Mwea division, Kirinyaga County-Kenya. Four hundred and sixty five house-hold heads were enrolled in this study by use of simple random sampling technique. METHODS: The study employed an analytical descriptive cross sectional design utilizing both quantitative and qualitative data collection methods. A pretested structured questionnaire, Focus Group Discusions (FGDs) and Key Informant Interviews (KII) guides were used for data collection. Descriptive statistics and Chi square tests and Fisher's exact tests were computed where applicable. Data from the FGDs and KIIs were analyzed using NUID.IST NUIRO.6 software. RESULTS: Significant associations between knowledge and demographic factors i.e. age (p = 0.011), education level (p = 0.046), were reported. Handwashing after visiting the toilet (p = 0.001), having a toilet facility at home (p = 0.014); raring animals at home (p = 0.031), households being affected by floods (p = 0.005) and frequency of visits to the paddies (p = 0.037) had a significant association with respondents practices and schistosomiasis infection. Further significance was reported on households being affected by floods during the rainy season (p < 0.001), sources of water in a household (p < 0.047) and having a temporary water body in the area (p = 0.024) with increase in schistosomiasis infection. Results revealed that respondents practices were not significantly associated with gender (p = 0.060), marital status (p = 0.71), wearing of protective gear (p = 0.142) and working on the paddies (p = 0.144). CONCLUSIONS: This study reveals that knowledge about the cause, transmission, symptoms and prevention of schistosomiasis among the Mwea population was inadequate, and that this could be a challenging obstacle to the elimination of schistosomiasis in these communities. Due to various dominant risk factors, different control strategies should be designed. Therefore, there is a need for integrated control programme to have a lasting impact on transmission of schistosomiasis infection. Control programs like mass drug administration need to go beyond anti-helminthic treatment and that there is a need of a more comprehensive approach including access to clean water, sanitation and hygiene. School and community-based health education is also imperative among these communities to significantly reduce the transmission and morbidity from schistosomiasis.

A comparative study on the reliability of the fluorescence microscopy and Ziehl-Neelsen method in the diagnosis of pulmonary tuberculosis.

Pulmonary tuberculosis (PTB) is the most common presentation of tuberculosis (TB) in Kenya. For the diagnosis of PTB the sputum smear is used because it is technically simple, non-invasive and cheap. The reliability of direct smear examination for the diagnosis of TB has however frequently been questioned. To address this problem, a study comparing the reliability of fluorescence microscopy (FM) and Ziehl-Neelsen (ZN) staining method for examination of direct smear in the diagnosis of PTB was carried out at the Respiratory Disease Research Unit Laboratory, Nairobi, Kenya. A total of 1480 sputum specimens collected from patients with suspected PTB were analyzed. Two direct smears were prepared from each specimen, one stained using FM and the other using the ZN method. Culture results were used as the gold standard for assessment. Specificity was 97% and 96% for FM and ZN methods, respectively. The sensitivity of the FM method was 80% and that of the ZN method 65% (p < 0.001). Overall agreement was 86.8%. Positive smears which were missed on the ZN stained smears (15%) contained low density bacilli on both FM stained smears and on culture. The use of FM greatly improves the diagnostic value of the sputum smear especially in patients with a low density of bacilli who are likely to be missed on ZN stained smears. The method is economical in both time and expense and is recommended for laboratories handling large numbers of sputum specimens.

Use of common reagent containers to stain sputum smears for acid fast bacilli using ziehl-neelsen technque

The use of common reagent containers for mass staining of sputum smears for acid fast bacilli (AFB) by the Ziehl-Neelsen (ZN:) Technique has previously been discouraged for fear of cross contamination. We undertook the present study to ascertain whether this fear has any justification. Out of 1296 smears prepared from 198 specimens including 9 known negative controls; 108 stainings were performed. 70 specimens and all positive controls were repeatedly positive on different stainings. 69 (99) cases and all positive controls were confirmed by culture. No carry over of AFB from positive to negative smears was experienced. Time; cost and staining mess was significantly reduced during mass eestaining. The use of a common container for staining of sputum smears for AFB by the ZN technique is not only economical but also ideal for laboratories where space is insufficient and larg numbers of sputum specimens are involved

Serum pepsinogen I in relation to some clinical features and complications of duodenal ulcer disease.

Fasting serum pepsinogen 1 was assayed in 60 patients seen at the Kenyatta National Hospital with endoscopy - confirmed active duodenal ulceration. Pepsinogen 1 values were also correlated with some clinical features and complications of this disorder. 54 (90%) of the patients had significantly elevated values when compared with age and sex matched controls. Although elevated values were found in patients with chronic dyspepsia, family history of ulcer dyspepsia, history of gastro-duodenal blood loss and in patients with virulent ulcers, this did not show statistical significance. The possibility of using serum pepsinogen I to identify duodenal ulcer patients and to predict the clinical course and complications of this disorder is discussed.